	<input type="hidden" name="<?php echo $c->prefix; ?>address_id" value="<?php echo $c->address->id; ?>"/>
	<input type="hidden" name="<?php echo $c->prefix; ?>address_modified" value="1" />
	<table border=0>
    	<tr><th>Line 1</th><td><input type="text" name="<?php echo $c->prefix; ?>address_line1" value="<?php echo $c->address->line1; ?>" /></td></tr>
    	<tr><th>&nbsp;</th><td><input type="text" name="<?php echo $c->prefix; ?>address_line2" value="<?php echo $c->address->line2; ?>" /></td></tr>
    	<tr><th>City:</th><td><input type="text" name="<?php echo $c->prefix; ?>address_city" value="<?php echo $c->address->city; ?>" /></td></tr>
    	<tr><th>State:</th><td><input type="text" name="<?php echo $c->prefix; ?>address_state" value="<?php echo $c->address->state; ?>" /></td></tr>
    	<tr><th>Zip:</th><td><input type="text" name="<?php echo $c->prefix; ?>address_zip" value="<?php echo $c->address->zip; ?>" /></td></tr>
    </table>